Fortified by a victory in Colorado Tuesday, a controversial campaign to let terminally ill patients access life-ending medication is moving on to other battlegrounds across the country.

By an overwhelming vote Tuesday, Coloradans approved a ballot initiative allowing physicians to prescribe lethal drugs to mentally fit, terminally ill adults who want to end their lives. Colorado is the sixth state to allow the practice, following Oregon, Washington, Montana, Vermont and California. Washington, D.C., is poised to approve similar legislation as soon as this month.

Colorado’s ballot initiative proposal met resistance from religious groups with moral objections and disability advocates leery of abuse of power. Opponents raised over $2.6 million, the bulk of which came from the Archdiocese of Denver. Supporters, who argued that terminally ill patients deserve the option to “die with dignity,” raised over $5.4 million, mostly from the Compassion & Choices Action Network.

“Colorado demonstrates what we have been saying: Voters want medical aid-in-dying laws because they want to have all possible options at the end of life,” said Toni Broaddus, acting national director of political affairs and advocacy at Compassion & Choices, which has been pushing for these laws across the country.

Advocates took the matter directly to voters after Colorado legislators rejected a similar bill last year. When all ballots were counted Wednesday, the ballot measure had won by a margin of nearly 2-1.

“When you pass a bill by such a significant majority,” Broaddus said, “it just demonstrates the non-partisan nature of this issue, and the widespread support.”

Colorado was one of 19 states to consider right-to-die laws this year. While many legislative sessions have ended, Broaddus said she is hopeful about pending legislation in New Jersey, and expects a bill in New York to be reintroduced in January.

Broaddus said Compassion & Choices has staff on the ground and networks of volunteers ready to work, in New Jersey, New York, Maryland, Minnesota, Hawaii, New Mexico and Massachusetts. That may be just the beginning: “Close to half” of the states will consider similar legislation in 2017, she predicted.

These efforts have gained steam since Brittany Maynard, an eloquent 29-year-old with terminal brain cancer, became the public face of the movement in 2014. Because her home state of California would not allow it at the time, Maynard moved to Oregon to acquire the lethal prescription that she used to end her life. Maynard’s husband, Dan Diaz, has spent the last two years urging other states to give patients that option.

The momentum also comes at a time when baby boomers are aging, confronting end-of-life planning for their parents and themselves, and seeking to “make sure we don’t have unwanted medical care,” Broaddus said.

In addition to its legislative efforts, Compassion & Choices is pushing courts to clarify state law in Massachusetts, New York and Vermont. That approach proved effective in Montana, where the state supreme court ruled in 2009 that state law protects physicians from prosecution if they help terminally ill patients die, effectively legalizing the practice.

These efforts across the country have sent opponents scrambling.

“Those who favor this are targeting every state,” said Rita Marker, executive director of the Patient Rights Council, which opposes such measures.

In Washington, D.C., her group has been working with African-American churches and low-income senior citizens who fear the laws will put disadvantaged patients at risk.

Colorado’s new law, based on Oregon’s 1997 law, requires patients to make two verbal requests 15 days apart, and one written request observed by two witnesses, to obtain lethal medication. Two doctors must affirm that the patient has six months or less to live.

While no malicious deaths have been reported since Oregon legalized the process nearly 20 years ago, Marker said the safeguards aren’t strong enough to prevent coercion by doctors, relatives or heirs. These laws require patients to self-administer the drugs, but Marker noted there’s no requirement that a physician witness the death.

“All of these safeguards stop when the so-called prescription is filled,” she said.

Diane Coleman, president of a national disability advocacy group called Not Dead Yet, said the laws create a dangerous financial dynamic in which insurance companies may deny expensive treatments but cover lethal drugs.

“Will insurers do the right thing or the cheap thing?” she asked.

Coleman also said a faulty diagnosis could prompt patients to end their lives earlier than need be. Her group, which has only three paid staff members, is working with networks of disability advocates to fight legislation across the country.

“Wherever the bills are brought up, we will be giving our best efforts,” she said.

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After Colorado, ‘Right To Die’ Movement Eyes New Battlegrounds

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